Individual
JENNIFER DEBOER ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LD
Contact information
Practice address
4552 SW NEVADA ST, PORTLAND, OR 97219-1548
(971) 235-4723
Mailing address
4552 SW NEVADA ST, PORTLAND, OR 97219-1548
(971) 235-4723
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
733
OR
Other
Enumeration date
03/08/2007
Last updated
10/01/2025
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